Articles: brain.
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Randomized Controlled Trial Multicenter Study
A trial of intracranial-pressure monitoring in traumatic brain injury.
Intracranial-pressure monitoring is considered the standard of care for severe traumatic brain injury and is used frequently, but the efficacy of treatment based on monitoring in improving the outcome has not been rigorously assessed. ⋯ For patients with severe traumatic brain injury, care focused on maintaining monitored intracranial pressure at 20 mm Hg or less was not shown to be superior to care based on imaging and clinical examination. (Funded by the National Institutes of Health and others; ClinicalTrials.gov number, NCT01068522.).
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Multicenter Study Clinical Trial
Intramuscular interferon beta-1a is effective in Japanese patients with relapsing-remitting multiple sclerosis: a pre-treatment versus treatment comparison study of gadolinium-enhanced MRI brain lesions.
Interferon beta (IFNβ) is standard therapy for multiple sclerosis (MS). The efficacy of intramuscular (IM) IFNβ-1a (AVONEX(®)) was assessed in 25 Japanese patients with relapsing-remitting MS (RRMS). ⋯ This first study of IM IFNβ-1a in Japanese patients with RRMS demonstrated a level of efficacy similar to that reported in Caucasian patients based on an assessment of pre-treatment and post-treatment gadolinium-enhanced lesions.
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Multicenter Study
Meningiomas in pregnancy: a clinicopathologic study of 17 cases.
Dramatic growth of meningiomas is occasionally encountered during pregnancy. While cell proliferation is often assumed, hemodynamic changes have also been touted as a cause. ⋯ Our series suggests that pregnancy-associated meningiomas located in the skull base are likely to require surgical intervention for visual complaints and cranial nerve palsies. The rapid tumor growth is more often due to potentially reversible hemodynamic changes rather than hormone-induced cellular proliferation.
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Multicenter Study Comparative Study
Spatiotemporal distribution of white matter lesions in relapsing-remitting and secondary progressive multiple sclerosis.
Multiple sclerosis (MS) is a chronic inflammatory disease of the central nervous system. MS lesions show a typical distribution pattern and primarily affect the white matter (WM) in the periventricular zone and in the centrum semiovale. ⋯ The results suggest a particular vulnerability to neurodegeneration during disease progression in a number of WM tracts.
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Archives of neurology · Oct 2012
Randomized Controlled Trial Multicenter StudyImpact of fingolimod therapy on magnetic resonance imaging outcomes in patients with multiple sclerosis.
To assess the impact of fingolimod (FTY720) therapy on magnetic resonance imaging measures of inflammatory activity and tissue damage in patients participating in a 2-year, placebo-controlled, phase 3 study. ⋯ These results, coupled with the significant reductions in relapse rates and disability progression reported previously, support the positive impact on long-term disease evolution.